Age-associated patterns of cardiovascular risk and disease phenotypes across diverse care settings: the GLOB-cAGE...

Reported prevalence of cardiovascular disease (CVD) risk factors and phenotypes varies widely. In multicohort analyses, such variation reflects population risk, care setting, and data capture. We harmonized baseline data from four analytic cohorts (N = 54,188, aged ≥50 yr) in five Global Cardiovascular Collaborative Network of Older Adults with Cardiovascular Disease member studies: pooled community (n = 956), primary care (n = 49,849), acute CVD registry (n = 2,723), and chronic CVD cohort (n = 660). Any risk factor was hypertension, diabetes, or dyslipidemia. Any CVD phenotype was ischemic heart disease, heart failure, or atrial fibrillation/flutter. At age 60-74 yr, any risk-factor prevalence ranged from 10.4% in primary care to 91.4% in the acute CVD registry (P < 0.001); any CVD phenotype prevalence ranged from 4.4% to 47.0% (P < 0.001). In the pooled community cohort, any risk-factor prevalence increased from 28.9% at age 50-59 yr to 85.0% at ≥75 yr (adjacent q < 0.001), whereas age-sex-standardized any CVD phenotype prevalence remained comparatively low (10.6%). Any CVD phenotype prevalence increased with risk-factor-count, with the clearest gradients in the acute CVD registry (35.8%-64.2%; P for trend < 0.001) and pooled community cohort (6.4%-19.6%; P for trend < 0.001). Among participants with any CVD phenotype, female age distributions were older than male distributions in primary care and the acute CVD registry (female-minus-male median age difference, +3.7 and +5.0 yr; both P < 0.001). Across diverse care settings, harmonized summary constructs identified interpretable patterns in cardiovascular risk and CVD burden. These real-world data support cardiovascular prevention across aging, highlight substantial CVD burden among women at older ages, and provide a framework for longitudinal analyses across real-world cohorts.NEW & NOTEWORTHY Using harmonized data from 54,188 older adults in GLOB-cAGE, this study shows that measured cardiovascular risk and disease burden differ markedly across care settings and data-capture contexts. CVD phenotype prevalence increased with accumulated hypertension, diabetes, and dyslipidemia, and women with CVD phenotypes were older than men in primary-care and acute registry settings. These findings support sex-aware cardiovascular prevention across aging, international real-world cohorts.